Physiotherapy might work just as well as surgery for treating lower back pain, according to a study.

Exercise rehabilitation reduced the pain associated with lumbar spinal stenosis - the leading cause of back pain among the elderly - just as effectively as an operation.

Lumbar spinal stenosis causes shooting or twinging pains, tingling, and numbness in the lower back, buttocks, and legs – known as sciatica.

The condition can sometimes be so severe it leaves people unable to walk and they may also lose their bladder or bowel functions.

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Physiotherapy might be just as effective as surgery at treating lumbar spinal stenosis, the leading cause of lower back pain among the elderly, a survey found

The pain is caused by a compression of the nerves in the back, which usually happens because the spinal canal – the space the spinal cord goes through – becomes more narrow as vertebrae, discs, muscles and ligaments in the spinal column are worn away with age.

The pain associated with the condition normally occurs when the person is standing or walking, and it usually feels better by bending forward at the waist.

At the start of the study, patients were at least 50 years old, with no underlying medical conditions such as dementia, severe vascular disease, cancer, or a prior heart attack.

Although they had to be able to walk at least a quarter mile without difficulty, most of them were sedentary or only mildly active, and were typically obese.

Patients in the surgery group were slightly younger, about 67 on average, compared with an average age of about 70 for patients receiving physiotherapy.

This physiotherapy group underwent a regimen consisted of twice-weekly rehabilitation sessions for six weeks.

They were allowed to opt out and have the surgery at any point during the study, and over an average two years of follow-up 47 of them, or 57 per cent, did just that.

The researchers discovered that no matter what group they started in, participants achieved similar reduction of pain and other symptoms after two years.

Surgery carries a 15 per cent risk of complications, whereas physiotherapy carried no risks, researchers said

Dr Jeffrey Katz, of Brigham and Women's Hospital in Boston, said: 'The study demonstrates that both surgery and physical therapy are reasonable choices; the person who goes down either path ends up in the same place a year or two later.'

Dr Katz added there's still a role for surgery in treating lumbar spinal stenosis, but there's no harm in trying physical therapy first.

Dr Anthony Delitto, of the School of Health and Rehabilitation Sciences at the University of Pittsburgh, who carried out the research, said: 'Surgery is a riskier procedure, with about a 15 per cent complication rate, and half of those are life-threatening.